Dicyclomine is a quaternary amine. Dicyclomine has anticholinergic activity, eliminates spasm of smooth muscles of the gastrointestinal tract and reduces the pain syndrome caused by it. In animal studies (in vitro studies using isolated guinea-pig small intestine), it has been established that the effect of Dicyclomine is mediated by the following mechanisms: direct action on smooth muscles, as indicated by the ability of dicycols to block histamine and bradykinin-induced spasms (atropine does not alter the response to these two agonists); a specific anticholinergic effect on the acetylcholine receptor sites, which is similar to the action of atropine (antimuscarinic activity). In in vivo studies in dogs and cats, Dicyclomine was approximately equally effective against intestinal spasms, which are caused by barium chloride and acetylcholine. The absence of a significant effect of Dicyclomine on the secretion of salivary glands (in studies in rabbits, dicyclosterin showed 1/300 of atropine activity), and also on the pupil (in studies on mice, the activity of mydriatic effects was about 1/500 of atropine activity).
Data on the possible mutagenicity and carcinogenicity of Dicyclomine hydrochloride in humans are absent. There were no long-term animal studies to assess the possible carcinogenicity of Dicyclomine.Dicyclomine did not have a dangerous effect on reproduction, conception and labor in studies in rats when administered at doses up to 100 mg / kg per day.Dicyclomine is well absorbed, and faster and easier after intramuscular injection (10 to 20 minutes) than after oral administration (after 1 to 1.5 hours). The elimination half-life is 1.8 hours. It is excreted from the body after 9 to 10 hours mainly with urine (approximately 80%) and in small amounts – with feces.

Indications
Colic (renal, hepatic, intestinal), algodismenorea.

Method of application of Dicyclomine and dose

Dicyclomine is administered intramuscularly, taken internally. The dose is set individually.
Before using Dicyclomine, it should be clarified whether the patient has tachycardia, because Dicyclomine can increase the heart rate.
Caution is prescribed Dicyclomine at high ambient temperature (due to decreased sweating, the risk of hyperthermia and heat stroke increases). It is necessary to know that diarrhea can be an early symptom of incomplete intestinal obstruction, especially in patients with colostomy or ileostomy. In these cases, dicyclosterin hydrochloride therapy is not indicated and, possibly, will be dangerous.
There are reports that in patients with hypersensitivity anticholinergic drugs can cause psychosis.
Action on the central nervous system manifests itself in the development of symptoms such as disorientation, confusion, short-term memory loss, dysarthria, hallucinations, ataxia, euphoria, coma, decreased anxiety, insomnia, weakness, mannerisms, agitation, inadequate emotional reactions. After discontinuation of dicyclosterine, these symptoms usually decrease within 12 to 24 hours.
When treating Dicyclomine, potentially dangerous activities that require increased attention, rapid mental and motor reactions (including the management of vehicles, mechanisms) should be avoided.

Contraindications for use
Hypersensitivity, obstructive diseases of the gastrointestinal, urinary and hepatic tracts, reflux-esophagitis, peptic ulcer and duodenal ulcer, severe ulcerative colitis (there may be a decrease in intestinal peristalsis, up to the development of paralytic intestinal obstruction, the appearance or exacerbation of toxic megacolon), myasthenia gravis , glaucoma, unstable cardiovascular system with acute bleeding, hypovolemic shock, children’s age (up to 6 months), pregnancy, ne The rate of breastfeeding.

Restrictions on the use
Impaired liver and kidney function (decreased kidney excretion may increase the risk of adverse reactions), autonomic neuropathy, tachycardia, including in hyperthyroidism (possibly amplification), heart disease (including coronary heart disease, congestive heart failure, tachyarrhythmia), hypertension (possibly exacerbation), hypertrophy of the prostate gland, hernia of the esophageal opening of the diaphragm, ulcerative colitis, age under 18 years.

Application in pregnancy and lactation
During pregnancy, the use of dicyclovir is contraindicated. Strictly controlled and adequate studies in humans are not conducted. In reproductive studies in rabbits and rats that received Dicyclomine hydrochloride in doses up to 33 times higher than the maximum recommended doses for humans (3 mg / kg or 160 mg / day), undesirable effects on the fetus or effects on fertility have not been revealed. Dicycloceridine is contraindicated in breastfeeding. It has been reported that Dicyclomine hydrochloride is excreted in breast milk; in children who are breastfed, development of a respiratory distress syndrome is possible. It is necessary to stop breastfeeding for the duration of Dicyclomine therapy.

Interaction of Dicyclomine with other substances
The effects of Dicyclomine, including side effects, may enhance drugs that have anticholinergic activity: class I antiarrhythmics (eg, quinidine), amantadine, antihistamines, benzodiazepines, antipsychotics (eg phenothiazines), monoamine oxidase inhibitors, nitrites and nitrates, narcotic drugs analgesics, tricyclic antidepressants, sympathomimetics.
Anticholinergic drugs (including Dicyclomine) counteract the effect of antiglaucoma drugs.
In the presence of increased intraocular pressure, anticholinergic drugs (including Dicyclomine) can be dangerous when used in conjunction with corticosteroids.
Anticholinergic drugs (including Dicyclomine) can affect the absorption in the digestive tract digoxin and increase the concentration of digoxin in the blood plasma.
Anticholinergic drugs (including Dicyclomine) can counteract the effects of drugs that alter the motor activity of the gastrointestinal tract (metoclopramide).
Antacids can act on the absorption of anticholinergic drugs (including dicyclosterin), so avoid sharing them.
Oppression with anticholinergic drugs (including Dicyclomine) secretion of hydrochloric acid counteracts the action of drugs that are used to test gastric secretion or therapy with achlorhydria.

Release Form
White Valium tablets notch.
10 tablets in a blister; one, two, five or three blisters in a box made of cardboard.

Pharmachologic effect
Antiulcer action.

Pharmacodynamics and pharmacokineticsCytotec tablets are antisecretory, anti-ulcer drugs and have also cytoprotectors properties.

Misoprostol is a synthetic analogue of prostaglandin E1, which has a protective effect on the intestinal mucosa and gastric. It improves the stability of the inner membrane of the stomach to the action of negative factors: malnutrition, alcohol, stress, non-steroidal anti-inflammatory agents; helps prolong peptic ulcers, stops the occurrence of erosive and ulcerative disorders.
Cytoprotective effect of the drug is associated with an increase in mucus production in the stomach and increase its own gastric mucosal bicarbonate secretion. The drug has also antisecretory activity, reacting with receptors of prostaglandin E-type. It has a direct effect on the cells of the stomach, slows down the night, both basal and stimulated secretion of hydrochloric acid, and reduces the amount of proteolytic activity of gastric juice. It weakens the basal production of endogenous pepsin. It increases blood flow to the stomach. The drug begins half an hour after administration and lasts a minimum of 3 hours. The effect has a pronounced dose-dependent. It increases strength and frequency of contractions of the myometrium and the muscles of the intestine.Pharmacokinetics
Rapidly absorbed (food intake slows absorption). The walls of the intestine and the liver to form biotransformed misoprostol pharmacologically active misoprostol acid. The largest concentrations are in about 12 minutes, it circulates in the bloodstream in a complex with proteins (90%). The half-life time may be up to 40 minutes. The equilibrium concentration of active substance in the blood is reached after 2 days, accumulation is not observed. Up to 80% of the dose is excreted by the kidneys, in violation of their operation may increase the half-life and an increase in the maximum concentration of 2 times.

Indications
Treatment and prevention of gastric mucosal lesions and 12 duodenal ulcer, ulcerative erosive nature, caused by including taking anti-inflammatory non-steroidal agents.
Medication abortion (medical abortion in most countries the drug is used without authorization and without the need for patient information on safe use).

Contraindications
✹ Cardiovascular disease.
✹ Hypersensitivity to the drug.
✹ Liver and kidneys.
✹ Endocrinopathies and destruction of the endocrine system.
✹ Diseases associated with dependence on prostaglandins.
✹ Anemia.
✹ Hormone-dependent tumors.
✹ Lactation.
✹ Age up to 18 years.
✹ Suspected ectopic pregnancy.
✹ The use of intrauterine contraceptive devices.
✹ Pregnancy (if the drug is not used for the purpose of an interruption).

Instructions for use (Method and Dosage)
Instructions on Cytotec provides a use of the drug for the treatment and prevention of peptic ulcer disease and does not spread the recommendations on the use of funds for abortion. The drug is taken orally with meals.
To treat ulcers caused by the use of nonsteroidal anti-inflammatory agents, manual prescribes Cytotec take 800 mg of the drug twice a day for 1-2 months.
For the prevention of ulcers caused by the use of non-steroidal anti-inflammatory agents, medicine taking 200 mg 2-4 times a day during the treatment period, non-steroidal anti-inflammatory agents.
Cytotec Abortion
Use for abortion up to 63 days only in combination with mifepristone, trained personnel in institutions with the ability to provide emergency assistance. In the later stages of the drug ineffective.

Interaction
When used together with antacids decreases the concentration of active substance in the blood.
When using a magnesium-containing antacids can not be ruled strengthening diarrhea.
In a joint application with diclofenac, or indomethacin stimulated side effects of the latter.

Storage conditions
Store in a dry place at temperatures up to 30 ° C. Keep away from children.

Shelf life
3 years.

Special instructions
The drug should be used with caution in patients with coronary heart disease, arterial hypertension, cerebral circulatory disorders, diarrhea, epilepsy, koronarokardiosklerozom, enterocolitis, hypersensitivity to prostaglandins.
In appointing the patients of childbearing age must first carry out a pregnancy test. The test should be negative for 2 weeks prior to application of the drug. Treatment is allowed to start only 2 days after the start of menstruation. Throughout the period of the reception should use reliable methods of contraception. Misoprostol increases uterine tone and can trigger a miscarriage.

For Kids
Do not use in patients under 18 years.

During pregnancy (and lactation)
The product may not be used during these periods with the exception of applications for the purpose of termination of pregnancy.
ATTENTION!
Information about medications online is a reference generalizing collected from publicly available sources and can not serve as a basis for decision-making on the use of medicines in the course of treatment. Before using the drug Cytotec you should consult with your doctor.